Shamala Pulugurtha, MS – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Mon, 08 Jan 2018 16:30:41 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.1 New Tool to Diagnose Adolescent Depression http://brainblogger.com/2007/07/11/new-tool-to-diagnose-adolescent-depression/ http://brainblogger.com/2007/07/11/new-tool-to-diagnose-adolescent-depression/#comments Wed, 11 Jul 2007 11:58:52 +0000 http://brainblogger.com/2007/07/11/new-tool-to-diagnose-adolescent-depression/ Psychiatry_Psychology2.jpgThe Centers for Disease Control and Prevention (CDC) estimates that between 1992 to 2004, the rate of hospitalization for depression has increased approximately 81% for females and 30% for males aged 5-19 years. In 2004, more than 5,000 US children and adolescents committed suicide and an additional 171,870 non-fatal self harm injury cases were reported. About 15-20% of American teens have experienced a serious episode of depression, which is similar to the proportion of depressed adults.

Eighty percent of the depression cases are readily treatable. But the numbers above state a different story. One possible reason could be improper diagnosis. Depression in adolescents can occur due stress associated with the normal maturation process. It can also occur as a result of a traumatic experience. It is however, difficult to diagnose depression in adolescents because it may manifest in several forms and can also be mistaken for normal teenage behavior.

Over the years, several different methods have been used to diagnose depression along with the physical examination. These include self-reports like the Center for Epidemiological Studies Depression Scale and Beck Depression Inventory and clinician reports like the Hamilton Depression Rating Scale and the Children’s Depression Rating Scale. These scales however, are not specific to adolescents and hence have been reported to have limited reliability in that age group. Also, these tests classify adolescents as either depressed or not depression and do not consider a substantial number of depressed teens with no apparent symptoms. Thus, some recently published studies have supported a dimensional model where depression is graded along a continuum from mild to severe.

In a study published recently in BMC Psychiatry, Dr. Revah-Levy et al. of the Université Paris Sud designed and tested a dimensional scale to diagnose adolescent depression called the Adolescent Depression Rating Scale (ADRS). Two initial versions of ADRS were constructed: one was a 11 item clinician-scale report and the other was a 44 item self-report scale. 402 adolescents were assessed and it was found that ADRS had acceptable psychometric properties.

This test has only been validated in French as of now but translations are being made into other languages. If successful, this can make a considerable difference in the way adolescent depression is diagnosed and that may in turn lead to better management of the disease and save so many young lives.

Reference

Anne Revah-Levy, Boris Birmaher, Isabelle Gasquest, and Bruno Falissard. The Adolescent Depression Rating Scale: a validation study. BMC Psychiatry 2007, 7:2.

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Problem Eating Behavior in Preschool Children http://brainblogger.com/2007/05/12/problem-eating-behavior-in-preschool-children/ http://brainblogger.com/2007/05/12/problem-eating-behavior-in-preschool-children/#comments Sat, 12 May 2007 18:03:43 +0000 http://brainblogger.com/2007/05/12/problem-eating-behavior-in-preschool-children/ Psychiatry_Psychology2.jpgGreek physician Hippocrates once said, “If we could give every individual the right amount of nourishment and exercise, not too little not too much, we would have found the safest way to health.” According to the National Institutes of Health, at least one out of five kids in the U.S. is overweight. The number of overweight children continues to grow. Over the last two decades, this number has increased by more than 50% and the number of “extremely” overweight children has nearly doubled. The prevalence of underweight children has, however, decreased and only 1.6% children in the developed countries are underweight. Several factors can contribute to weight problems including improper caloric intake, genetics, and behavioral patterns.

In a study published in the International Journal of Behavioral Nutrition and Physical Activity, Lise Dubois and collegeues analyzed the social issues that cause problem eating behavior and in turn, the effects of this behavior on the weight of preschoolers. They analyzed 1,498 children from the Longitudinal Study of Child Development in Canada and observed that eating behaviors in children range from picky eating, irregular eating, overeating and binge eating. Factors like low birth weight and insufficient income contributed to picky eating. Single-parent family status, obese or overweight parents and gender played a role in overeating. Interestingly, low family income was a factor in overeating as well. A greater proportion of picky eaters were underweight at 4.5 years while overeating contributed to being overweight at that age. This study establishes a strong connection between family environment and weight problems.

Research in the past has shown that childhood weight issues could continue into adolescence and adulthood. Thus, a comprehensive program involving parents, teachers and children should be implemented all over the country. “Prevention is a marathon, not a sprint,” says Linda Johnson, Director of School Health Programs for the North Dakota Department of Public Instruction. The Departments of Health and the Surgeon General’s Office have issued several guidelines like Physical Activity Guidelines for Children, Youth and Adults; Bright Futures in Practice: Nutrition; and Guidelines for childhood obesity prevention programs to name a few. But, it is important to spread awareness about these resources to teachers, children and parents. This is important to help children who are suffering unnecessarily from long-term health and emotional impacts of adult-like medical problems at younger ages.

References

Lise Dubois, Anna Framer, Manon Girard, Kelly Peterson, and Fabiola Tatone-Tokuda. Problem Eating Behaviors related to social factors and body weight in preschool children: A longitudinal study. Int J Behavioral Nutrition and Physical Activity 2007, 4:9.

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Personality and Disease http://brainblogger.com/2007/05/03/personality-and-disease/ http://brainblogger.com/2007/05/03/personality-and-disease/#respond Thu, 03 May 2007 19:30:24 +0000 http://brainblogger.com/2007/05/03/personality-and-disease/ BioPsychoSocial_Health.jpgAn Indian sage said some 4000 years ago, “There are two classes of disease–bodily and mental. Each arises from the other. Neither can exist without the other. Mental disorders arise from physical ones, and likewise, physical disorders arise from mental ones.” The debate between duality and unity of the mind and body has been going on for centuries. Most conventional medical practitioners treat disease symptoms or the organisms. But others believe in treating the person rather than the disease. They consider that factors such as stress, personality, and the environment play a role in the development of a disease.

In recent years, a belief has been growing that personality and coronary heart disease are linked in some way. Scientists have carried out several studies to demonstrate a connection between diseases and personality, especially a person’s ability to react to stress. In a study published in BioPsychoSocial Medicine, Flaa et al. (2007) selected 87 men from the 1st, 50th, and 99th percentiles of a blood pressure screening. The researchers assessed fifteen personality traits using the Karolinska Scales of Personality and recorded patients’ cardiovascular and catecholamine responses to mental arithmetic stress test (MST) and cold pressor test (CPT). Their findings indicated that cardiovascular and catecholamine stress reactivity depended on the type of personality, without any single trait being dominant. The results clearly indicated how certain personality traits like detachment, distress and inhibition of emotions had an exaggerated response to a cardiovascular stress test, which in turn is an indicator of future morbidity and mortality.

Two very important questions follow these studies. Can we reduce our susceptibility to disease by learning to manage stress more efficiently? Also, can psychological treatment prolong the life of individuals suffering from cancer or heart disease?

The answer to both these questions is yes. It is possible to teach people how to cope with stress and express their anger in a socially acceptable way. Grossarth-Maticek developed a behavior therapy method in which the goal is to make disease-prone individuals realize the drawbacks of their responses and replace them with healthier responses. In all the his studies, the survivors from the therapy group outnumbered the survivors from the control group by more than two to one.

These studies indicate a need for a new and a more holistic approach to treating patients. This kind of preventive care could be much cheaper than treating a full-blown disease.

References

Arnljot Flaa, Oivind Ekeberg, Sverre Erik Kjeldsen, and Morten Rosturp. Personality may influence reactivity to stress. BioPsychoSocial Medicine 2007, 1:5

Hans Eysenck and Michael Eysenck. Mind Watching. Prion Books Ltd 1995

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